Provider Demographics
NPI:1518372796
Name:CURELLA, NICKI (MPT)
Entity Type:Individual
Prefix:
First Name:NICKI
Middle Name:
Last Name:CURELLA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4726 E DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85205-6300
Mailing Address - Country:US
Mailing Address - Phone:480-772-5305
Mailing Address - Fax:480-699-3826
Practice Address - Street 1:4726 E DECATUR ST
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-6300
Practice Address - Country:US
Practice Address - Phone:480-772-5305
Practice Address - Fax:480-699-3826
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33972251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics